MICHELLE LYN MINIKEL (NPI# 1093913113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093913113 |
| Entity Type | Individual |
| Full Name | MICHELLE LYN MINIKEL |
| Credential | MD |
| Practice Address |
704 S Webster Ave Suite 200 Green Bay WI 54301-3528 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 9204333456 |
| Practice Fax Number | 9204333469 |
| Mailing Telephone | 9204457222 |
| Mailing Fax Number | 9204457289 |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2019-06-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 64141-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807771900 | 05 | |
| WI | 1093913113 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3263 Eaton Rd, Green Bay, WI 543116830 | 9204336700 | 9204336719 |
| 704 S Webster Ave Ste 201, Green Bay, WI 543013528 | 9204333410 | 9204333419 |
| Street Address |
704 S WEBSTER AVE SUITE 200 |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932102787 | Pamela C Baeten | Internal Medicine | 704 S Webster Ave, Ste 500, Green Bay, WI 54301-3528 | 2005-05-24 |
| 1164959680 | Cynthia L Suplinski | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2017-05-15 |
| 1073063681 | Bellin Memorial Hospital Inc | Internal Medicine | 704 S Webster Ave, Suite 501, Green Bay, WI 54301-3528 | 2016-10-06 |
| 1265986731 | Susan Molenaar | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2016-08-12 |
| 1225403157 | Bonnie L Dejardin | Nurse Practitioner | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2015-12-03 |
| 1437531720 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 A, Green Bay, WI 54301-3533 | 2015-06-23 |
| 1841672516 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 B, Green Bay, WI 54301-3533 | 2015-06-18 |
| 1407295389 | Michael Chistopher Popelars | Dentist | 704 S Webster Ave, Suite 402, Green Bay, WI 54301-3528 | 2013-06-24 |
| 1013350958 | New Dermatology Group Ltd | Dermatology | 704 S Webster Ave, Green Bay, WI 54301-3528 | 2013-04-10 |
| 1235444225 | Melissa A Anderson | Nurse Practitioner | 704 S Webster Ave, Suite 300, Green Bay, WI 54301-3528 | 2010-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528259397 | Venkata Ravi Kiran Kadipi Reddy | Family Medicine | 2793 Lineville Road, Green Bay, WI 54307 | 2007-08-07 |
| 1104022128 | Bellin Memorial Hospital Inc | Family Medicine | 704 S Webster Ave Ste 201, Green Bay, WI 54301-3528 | 2007-06-26 |
| 1942336839 | Richard Gordon Heidorn | Family Medicine | 2833 Riverside Dr, Green Bay, WI 54301-1635 | 2007-02-26 |
| 1720137656 | Daniel G Koster Md Sc | Family Medicine | 744 S Webster Ave Fl 5, Green Bay, WI 54301-3505 | 2007-01-09 |
| 1356424691 | Marjorie J Delo | Family Medicine | 2595 Development Dr Ste 140, Green Bay, WI 54311-4267 | 2006-10-23 |
| 1700894433 | Suzanne H Barnes | Family Medicine | 1565 Allouez Ave, Green Bay, WI 54311 | 2006-08-05 |
| 1407871684 | John Tracy Warren | Family Medicine | 1685 Macarthur St, Green Bay, WI 54301-2454 | 2006-07-12 |
| 1255364642 | Gail S Carels | Family Medicine | 2502 S. Ashland Ave, Green Bay, WI 54304 | 2006-07-08 |
| 1346293941 | Bellin Memorial Hospital Inc | Family Medicine | 1976 Lime Kiln Rd, Green Bay, WI 54311-4417 | 2006-05-18 |
| 1073566725 | Bellin Memorial Hospital Inc | Family Medicine | 2015 Shawano Ave, Green Bay, WI 54303-2606 | 2006-05-17 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.